NPI | 1205031663 |
---|---|
Doing Business As | MISSION TRAILS DENTISTRY |
Entity Type | Organization |
Authorized Contact | BRADLEY A. ROSS President 619-582-9700 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 34414) |
Enumeration Date | 2007-06-17 |
Last Update Date | 2020-08-22 |